A Practical Approach to Pediatric Chest

Ricardo Faingold, MD.

Department of Medical Imaging

Montreal Children's Hospital

McGill University

Maputo 2016

ricardo.faingold@muhc.mcgill.ca

Objectives

Identify normal

Tips and clues to interpret plain

films

Review of common pediatric X-

rays

Chest Radiographs

CXR

CXR

Chest Radiograph

Thymus

Normal age related appearances

Infant-toddler: Large ant. Mediastinum with wavy and

hazy borders and soft density

Child to early teen: Thymus usually not visualized-

AP CXR

Young adult: Thymus not visualized- AP CXR

Variants

“Sail” sign

Thymus extending down to diaphragm

Spectrum of Thymic appearances

Spectrum of Thymic appearances

CT Correlation

Infant to older child

Older child to early teen Early teen to adult

MRI Correlation

Pneumonia

Typical Bacterial Appearances

Round Pneumonia: represent

pneumococcal infection in early

consolidative phase

Lobar Pneumonia: mostly

bacterial. May also happen with

viral disease.

Role of Imaging

confirm or exclude pneumonia

exclusion of other pathology

evaluate complications

Consolidation

Segmental to lobar

Air-space disease or Consolidation

(air-bronchograms)

Pleural effusions

Bacterial (Pneumococcal, most common)

Pleural Effusion

Pleural Effusion

Thymus x Mediastinal Masses

Assess airway displacement and

narrowing

Assess Density

Additional findings

Effusion

Atelectasis

etc

Thymus x Mediastinal Masses

Thymus x Mediastinal Masses

Mediastinal enlargement

Round Pneumonia x Tumor

Opaque hemithorax

Opaque hemithorax

Hyperlucent hemithorax

Hyperlucent hemithorax

Cases

2 y old female

Neonate at birth

3 y old male

2 w old female

Thank You!